10.10.13 (Delayed post. Got home late last night and the internet wasn’t working.)
On call again today! I drove to work at 7 am in sideways pelting rain/snow. Other than that it was a nice quiet morning. The best part of my long day (I stayed after hours for this) was that I got to deliver a baby!!! (I think I should write more often about how I love delivering babies on here, because every time I do, the next day I get a delivery (well…2 for 2 so far :)). I actually had 2 OB (pregnant) patients, one was overdue, who came in active labor. And another preterm labor rule out with a possible, but not clearly diagnosed pregnancy complication (intrahepatic cholestasis of pregnancy), that should be transferred to Anchorage for closer monitoring. Although it seemed to me that we could have maybe kept here here for longer, a doctor who has been here much longer thought she would be better served in Anchorage. Especially because if the weather turns bad, she could get stuck here… And the doctors that have been here for a while have seen their share of difficult situations.
It made me consider further this thin edge that we practice on, because I see extremely competent, amazing providers who are excellent at what they do terrified and really disliking OB, unless it’s totally risk-free. A nurse told me a story about a doctor who came up here and had a baby die in the womb while on a MedEvac to Anchorage; she left and never came back. It must be so emotionally traumatizing and painful. And I have no idea how I will handle a situation like that. On one hand, I saw a lot of life and death, both infant and maternal mortality in PNG, and it is more accepted as a part of the natural cycle of life there (all death is more accepted than it is here, which sometimes feels like we have unrealistically high expectations that no-one is ever supposed to die, and if they do, it is a medical failure). But on the other hand, if a mother, or a baby were to die while I was the one in charge to make decisions, I really don’t know what full effect it would have on me. Would it be so painful that I couldn’t bear to stay here any longer? Would it burn me out? Would it make me too terrified to want to continue delivering babies? How would I deal with it? How would I respond to it? I love delivering babies. I think it is one of the most amazing miracles…life is a miracle. But would a bad experience take away this joy? would it make it too heavy of a risk to bear? I don’t think there is any way to know until it happens. And I hope with all my heart that it doesn’t happen.
– 2 chest pain rule-outs (have to make sure it’s not a heart attack or something else causing the chest pain that can be bad).
– 1 call from a village about an intoxicated man involved in an accident with a head injury and most likely multiple broken bones that we sent out a MedEvac. He ended up refusing to come in as there was alcohol involved, and he was in a “Dry” (supposed to be alcohol-free) village.
– 1 patient with a GI (gastrointestinal) bleed with a complicated medical history who we needed to MedEvac to Anchorage.
– 2 pregnant patients, one delivered (so two patients to round on tomorrow am!), one sent to Anchorage by commercial flight
– A few calls from the villages.
– A couple of intoxicated patients that came in just for observation and release to either jail or the outside world (most likely back to the bars).